CHARTZ

图表

基本信息

批准号：
10685464
负责人：
Michael Jeffrey Vinikoor
金额：
$ 31.12万
依托单位：
UNIVERSITY OF ALABAMA AT BIRMINGHAM
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-10 至 2026-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10685464
关键词：
18 year old Acceleration Address Adult Affect Africa South of the Sahara Alabama Alcohol abuse Alcohol consumption Alcohols Behavioral Biological Markers Caring Clinic Clinical Cognitive Cognitive Therapy Complex Computerized Medical Record Continuity of Patient Care Counseling Data Diagnostic Effectiveness Elements Eligibility Determination Enrollment Epidemic HIV HIV Infections HIV/AIDS Health Personnel Hybrids Incidence Individual Intervention Measures Mental Health Mental disorders Modeling NIH Office of AIDS Research Outcome Outcome Measure Participant Patient Outcomes Assessments Persons Pharmaceutical Preparations Population Prevalence Prevention Prevention program Professional counselor Program Research Project Grants Protocols documentation Provider Psyche structure Public Health Public Sector Randomized Randomized Controlled Clinical Trials Randomized, Controlled Trials Research Research Project Grants Resource-limited setting Symptoms Testing Translational trial Trauma Viral Zambia alcohol abuse therapy alcohol comorbidity alcohol intervention alcohol misuse antiretroviral therapy arm behavioral health brief alcohol intervention brief intervention clinical care comorbidity comparative effectiveness cost cost effective cost effectiveness cost-effectiveness ratio depressive symptoms design effectiveness evaluation effectiveness/implementation trial epidemic response evidence base experience flexibility follow-up health goals health related quality of life implementation determinants implementation evaluation improved incremental cost-effectiveness intervention delivery low and middle-income countries marginalized population mortality novel peer phosphatidylethanol pilot test programs psychologic randomized trial reduced alcohol use response screening standard of care substance use therapy adherence trauma symptom treatment effect treatment program trial design

项目摘要

Project Summary/Abstract The intersection of unhealthy alcohol use and HIV infection is most significant in sub-Saharan Africa (SSA) where HIV prevalence exceeds 20% in some populations and alcohol consumption is on the rise. Most HIV treatment and prevention programs in SSA do not have evidence-based alcohol interventions and the professional mental health workforce is extremely limited. Alcohol brief interventions (BI), which have been moderately effective in other settings, were not effective in SSA for unhealthy alcohol use among people with HIV in several previous trials. Unhealthy alcohol use is often complicated by comorbid mental illness and/or other substance use. We previously demonstrated the feasibility, acceptability, and potential effectiveness of a transdiagnostic model called Common Elements Treatment Approach (CETA) for people with HIV and unhealthy alcohol use. CETA was designed for delivery by lay providers (non-professionals with limited or no previous mental health experience) and can address a range of conditions (including unhealthy alcohol use) within a single protocol delivered over 6-12 therapy sessions. CETA was evaluated in 3 previous randomized trials and found to be effective for a range of conditions in trauma-affected and marginalized populations. CETA HIV Alcohol Reduction Trial in Zambia (CHARTZ), a research project within the Zambia Alabama HIV Alcohol Comorbidities Program, is a hybrid effectiveness-implementation trial to evaluate the effects of CETA, and a novel alcohol BI, on HIV, alcohol, and comorbidity outcomes. Adults (18+ years old) with HIV, unhealthy alcohol use, and suboptimal engagement in HIV care at public sector HIV clinics in Lusaka will be enrolled and randomized to the standard of care (ART adherence counseling), BI alone, or BI plus CETA. The BI and CETA will be provided by HIV peer educators, a cadre of lay counselors who are embedded at HIV clinics across Zambia. Patient reported outcome measures (for alcohol use, mental illness, and other substance use) and HIV electronic medical records (for ART adherence, retention in HIV care, viral suppression) will be used to assess trial eligibility and evaluate outcomes at 6 and 12 months. Phosphatidylethanol, a direct alcohol biomarker, will be measured to strengthen assessment of trial outcomes. Implementation factors related to the integrated delivery of CETA and the BI will be evaluated including cost and cost effectiveness. In summary, CHARTZ will generate evidence on psychological treatments for unhealthy alcohol use that have strong potential for implementation in low-resource settings and can address complex and overlapping behavioral issues that undermine HIV treatment and prevention.

项目概要/摘要不健康饮酒与艾滋病毒感染的交集在撒哈拉以南非洲 (SSA) 最为显着，那里一些人群的艾滋病毒感染率超过 20%，酒精消费量正在上升。大多数艾滋病毒治疗 SSA 的酒精干预和预防计划没有基于证据的酒精干预措施，也没有专业的心理干预措施。卫生人力极其有限。酒精短暂干预（BI），在以下方面已取得一定效果：在其他环境下，在 SSA 中对艾滋病毒感染者不健康饮酒的情况没有效果。试验。不健康的饮酒通常会因合并精神疾病和/或其他物质使用而变得复杂。我们先前证明了跨诊断模型的可行性、可接受性和潜在有效性针对艾滋病毒感染者和不健康饮酒者的称为通用要素治疗方法 (CETA)。欧洲经济贸易协定专为非专业人士（之前心理健康状况有限或没有心理健康状况的非专业人士）提供经验），并且可以在一个方案中解决一系列问题（包括不健康的饮酒）进行了 6-12 次治疗。 CETA 在之前的 3 项随机试验中进行了评估，结果发现对受创伤和边缘化人群的一系列病症有效。 CETA 艾滋病毒酒精减少赞比亚试验（CHARTZ）是赞比亚阿拉巴马州艾滋病毒酒精合并症项目的一个研究项目，是一项混合有效性实施试验，旨在评估 CETA 和新型酒精 BI 对 HIV 的影响，酒精和合并症结果。感染艾滋病毒、不健康饮酒和身体状况不佳的成年人（18 岁以上）参与卢萨卡公共部门艾滋病毒诊所艾滋病毒护理的人员将按照标准进行登记和随机分组护理（ART 依从性咨询）、单独 BI 或 BI 加 CETA。 BI 和 CETA 将由 HIV 同行提供教育工作者，一支由非专业顾问组成的骨干队伍，驻扎在赞比亚各地的艾滋病毒诊所。患者报告的结果措施（针对酒精使用、精神疾病和其他物质使用）和 HIV 电子病历（针对 ART 依从性、艾滋病治疗的保留率、病毒抑制）将用于评估试验资格和评估结果 6 个月和 12 个月时。将测量直接酒精生物标志物磷脂酰乙醇以加强评估试验结果。将评估与 CETA 和 BI 集成交付相关的实施因素包括成本和成本效益。总之，CHARTZ 将生成心理治疗的证据对于不健康的饮酒行为，在资源匮乏的环境中具有很大的实施潜力，并且可以解决复杂且重叠的行为问题破坏了艾滋病毒的治疗和预防。